It’s all about portability.
A federal regulation proposed February 11 would require physicians’ offices to not only share medical records electronically with patients via their smart phones, but to implement systems which let patients electronically transfer those medical records to another care provider if the patient requested it.
In some cases, patients will want to use that capacity to digitally send records from your office to a complementary care provider. In other instances, it’ll mean “Hasta la vista, baby!”—or “Hola, new patient!” if such a record comes your way.
The 724-page proposed regulation is so dense with information technology terminology that it’s only slightly easier to read than those etchings on the Rosetta Stone. However, if you have something to say about it, comments can be submitted for 60 days after publication in the Federal Register, which had not happened yet as of this writing.
Here are some highlights.
Smart Phone Records Access for Patients
The rule would allow patients and providers access through either smart phones or computers. There are predictions that the application programming interfaces (APIs) contemplated by the federal rules will work faster and more simply with smart phones.
For example, some current online patient portals (such as the one this reporter uses at California Blue Shield) make it necessary to have a smart phone handy to receive a verification code and then input it into the browser during each computer login—an annoying step, which a smart phone completely bypasses. Others, such as the Best-in-KLAS* MyChart from Epic, the leading health care enterprise electronic health record (EHR) vendor, operate more simply and smoothly.
Smaller Practices Penalized?
The rule could cause pain for any physician practice or ambulatory surgery center with either no clinical computer system or an old one.
Most of modern hospital, surgery center, and physician practice EHRs (see below) already have patient portals. Some of these systems’ vendors will have to add the feature to allow patients to transfer their medical records online between your system and that of another care provider.
The penalty if your office doesn’t get up to speed? None for providers, the rule seems to say, other than patient pressure to get with the program. The penalties in the proposed rule all seem to be aimed at healthcare information technology vendors, in the form of a risk that they won’t be certified by the federal Office of the National Coordinator for Health Information Technology (ONC). For this and a host of other reasons, if your organization is shopping for a new EHR, make sure it’s certified by ONC.
“The proposed rule is designed to increase innovation and competition by giving patients and their healthcare providers secure access to health information and new tools, allowing for more choice in care and treatment,” an announcement by the Department of Health and Human Services (HHS) says. “It calls on the healthcare industry to adopt standardized application programming interfaces (APIs), which will help allow individuals to securely and easily access structured EHI (electronic health information) using smart phone applications.”
“The proposed rule places a strong focus on a patient’s ability to access their health information through a provision requiring that patients can electronically access all of their EHI (structured and/or unstructured) at no cost. Finally, to further support access and exchange of EHI, the proposed rule implements the information blocking provisions of the (21st Century) Cures Act.”
Insurers Are Affected Too
The proposed rule also would require insurers to swap data more efficiently with care providers. That could eventually lead big benefits for providers, including that of making the headache of pre-authorizations simpler, and simpler exchange of medical data needed for reimbursement. There is a non-government provider-insurer project called Da Vinci which is working on greater interoperability between caregivers and insurers. The federal rule proposes to use the Da Vinci Project’s Fast Healthcare Interoperability Resources Specification.
*KLAS is a company which uses user surveys to rank health care information systems. Its rankings of the best patient portals in EHRs, and some it deems not so good in 2019, can be found at this web page.
The Epic EHR already has an API called Share Everywhere, which lets patients transfer their records to any other caregiver, or anyone else they want to receive it. Thus, in some cases, EHR vendors are ahead of the proposed rules, at least on the patient portal side.
